HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l /
Date: r9 dslUed Permit Number: 1 y "�
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ft ld°Il mit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
PRClPt3SEDIMR01/EI111ENT.LQCATlL7N '.
Address: 10000 S OCEAN DR 602
Legal Description: THE MIRAMAR UNIT 602 AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 4502-701-0029-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Vander Kooi
Setbacks Front Back: X Right Side: Left Side:
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Install 1 accordion shutters
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itional work to be nertormed under this permit—check all apply:
11HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric El Plumbing OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 4,639.00 Utilities:i Sewer E]Septic Building Height:
QN£R/LESSlwL�; '6 � CtNTRAGTUE ,� :R
Name Richard Vander Kooi,Joseph&Cynthia Baumann Name: Michael Heissenberg
Address:735 144th Ave. Company: Expert Shutter Services
City: Holland State:MI Address: 668 SW Whitmore Dr
Zip Code: 49424 Fax: City: Port Saint Lucie State:FL
Phone No.616-403-7990 Zip Code: 34984 Fax: 772-871-0990
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: Callexpert@aol.com
from the Owner listed above) State or County License: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
3
S P.�LEMENTAL CON RllCTIQN LIENU1lU INFCiRMATION �' � � h
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: rite Inc. Name:
Address:6355 NW 36th St Suite 305 Address:
City: Virginia Gardens State: FL City: State:
Zip: 33166 Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
Signature of Own e Lessee/Contractor as ent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St.Lucie
The forgoing instrum nt was acknowledged before me The forgoing instru, ent was acknowledged before me
this�day of 20p�by this�day of 204z—by
Michael Heissen4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
&A
Iou,)Qt 6 ( �A� &0.oil
(Signature of Notary Public-State of Florida) (Signature of�Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced a
�oS Ass NOTARY PUBLIC
Commission No. GG258038 AAA 1)Shanon O'Shea Commission No. GG258038 oQ I
o� NOTARY PUBLIC -+STATE OF FLO A
-STATE OF FLORI A Comm#GG2580
Comm#GG258038 E x
Revised 07/15/2014 • CE 19�� Expires 9/12/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS